Reproductive Writes: Sex In The Dark

Writer for the Washington City Paper Amanda Hess took to the streets to interview men on their knowledge of birth control methods for her column The Sexist. She turned up much confusion, some blind optimism and a whole lot of ignorance. I was particularly intrigued by the guy who got so uncomfortable with his own description of the birth control pill as 'hormonal control' that he freaked himself in to some kind of feminist epiphany. But as we all laugh hard at the men's answers, perhaps take a moment to think. How much you really know about how the Pill, the patch, the ring or the emergency contraceptive pill works?

A survey by The National Campaign To Prevent Teen And Unplanned Pregnancy looked into the 'misconceptions' and 'magical thinking' surrounding birth control. The report showed 30% of those asked claimed to know 'little or nothing' about condoms and 63% felt similarly about the birth control pill. 56% had not heard of the contraceptive implant. Of the young men and women who said it was very important that they avoid pregnancy at this time in their lives, 34% thought it was still likely that they would have unprotected sex in the near future. The findings reminded me of a UK study published last year that discovered widespread acceptance of contraceptive myths - myths like using Coca-Cola and crisps as oral contraceptives and chicken skin being a handy alternative to condoms.

According to the organization's research, lack of knowledge about contraceptive methods leads to many young people being worryingly casual about their contraception use. I was struck by this, as in my own experience ignorance led me to double and triple-up on methods. Suspicion about the effectiveness of the Pill or condoms and lack of understanding of the way methods work is shown in the survey to produce a nonchalant attitude towards protection. But I - and many women I know - have used the fear that comes from this confusion as reason to be beyond paranoid and say, for example, use the Pill and condoms, take the emergency contraceptive when panicked and then buy up packs of pregnancy tests, stressing for weeks. I think the lack of understanding about how methods work is surely linked to a lack of knowledge about how women's bodies work. If we don't know how, when or why we are able to get pregnant then we are less likely to understand how to prevent ourselves getting pregnant. Our misconceptions about contraception are intrinsically tied to our misconceptions about our bodies.

Until I decided to get myself intensively educated about preventing pregnancy, what I took in from my friends, TV and visits to the doctor helped me to be just about as knowledgeable as I am about how the Internet works (not very). Just as I use the Internet all the time and rely on it for some very important elements of my life without having a clue about how it even gets words on a screen, I used the birth control pill for more than a decade without thinking about how it worked beyond what I got from a ten-minute consultation and a couple of magazine articles. We know we can't rely on major news channels to give us the full picture of world events, we have to go looking for alternative sources of information. Well, when it comes to contraception it's necessary to be just as proactive in gathering the info we need to know. When faced with statistics like those in this survey, it's clear that many of us do not have this information. Comprehensive, holistic education needs an investment of money and time that Planned Parenthood and other outreach organizations are not likely to see as long as the moral conservatives have their stronghold on the government. Until that changes, it's on us to educate ourselves and encourage others to do the same.

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Comments

I am a virgin, so I don't have any direct experience with this, but I can't imagine not using 2 forms of protection when I do eventually become sexually active. I have a very irregular period. I am often late and sometimes I skip entire months. I couldn't stand the nerves of waiting for my period to come every month, if it came that month, to confirm that I was not pregnant. And how is using 2 forms of BC paranoid? I always thought using a barrier method (condoms) in conjunction with another form (pill, nuvaring, IUD, etc) was a very good idea. As we all know sometimes BC fails. For women who absolutely do not want to get preganant (HELL NO) doubling up on BC seems like the way to go.

And please do not give abortion as the solution to BC failure. Not every woman is comfortable with that procedure.

Sorry, I hope I'm not derailing here. I see why it is so disturbing that so many people are completely ignorant about BC. I just don't understand why its paranoid to use 2 forms of BC.

As far as I know, and I feel pretty knowledgeable on the subject, doubling up on contraceptive methods can be helpful. A hormonal-control BC, like the pill/implant/patch/ring/etc, is somewhere around the 92% to 98% effectiveness depending on the type of BC and how you take it. Barrier methods, like condoms and diaphragms, are around 85-90% effective. Using one of each can be great for preventing pregnancy because you decrease your chance with the back up method, plus with condoms you get STI prevention.

However, doubling up on one kind of contraceptive does NOT increase the effectiveness, it in fact decreases is substantially. Using two kinds of hormonal BC, say trying to use the pill and the patch, will not make you super immune to pregnancy. It would most likely make you rather sick from the side effects and send your menstrual cycle through the ringer. Same goes for doubling up on condoms. It's a huge misconception out there that using two condoms at once, 'double backing it' as its some times called, will give you twice the barrier protection. Again, it will NOT increase effectiveness, the friction between the two condoms will harm the integrity of the condoms, possibly creating holes and tears through which the bad juju can escape.

So no, its not paranoid to double up on BC, it can be a very good and sound judgment call, if the methods work for you. However, once you become sexually active, it can be pretty easy to become paranoid about unplanned/unwanted pregnancies, it is after all called a pregnancy scare for a reason :)

Oops, I wasn't clear enough. I didn't mean doubling up on the same or similar BC. I cringe when I hear about women using multiple forms of hormonal BC. "Please Stop! You're short circuiting your poor endocrine system! Use a condom in place of the extra patch-pill-ring!" Plus with all the focus that pregancy prevention gets people forget about STDs and hormonal BC does not protect against them. (I will admit that I am a little paranoid about STDs) When I do become sexually active (I am embarrassingly old for a virgin) I want to be as safe as I reasonably can be.

You are definitely correct in wanting to use BOTH a hormonal birth control method AND a condom, considering the condom, not the pill, etc., is going to be the only thing to help prevent contraction of STI's, as well as prevent pregnancy. And considering that HPV alone affects up to 75% of males and females ages 15-49, (according to MS. magazine) a condom is a MUST. Regardless of your age, I greatly respect your choice to wait for sex and the fact that you are informing yourself and taking precautions before you ever try it. ALWAYS, ALWAYS, ALWAYS use a condom in addition to your regular method of birth control.

By 'paranoid' I mean using contraceptive methods effectively, safely and appropriately and still convincing yourself you are probably pregnant for a week every month - when you're really very unlikely to be. For me this paranoia was/is rooted in being detached from my body and its workings since my mid-teens through taking the Pill and as such developing a suspicion and fearfulness of my own reproductive abilities.

I was on the Pill for years and never used it alone as a method, but always with condoms. I used the Pill even when I wasn't having sex. The Pill had a detrimental effect over time on my emotional state and general health - shutting down my ovulation cycle for a decade took its toll.

When I came to realize this I was intrigued by my insistence on continuing to use the Pill - and considered it had much more to do with my desire to control my body - periods, hormonal changes - than birth control. I had become dependent on the Pill as a way of 'dealing with' my femininity, sexuality and body functions. I found coming off the Pill very difficult, partly because of the physical withdrawal symptoms - surge in anxiety, sleeplessness, emotional instability - but also because of my psychological attachment to popping a drug that harnessed my body and all its frightening potential for not just pregnancy but everything else living female bodies do.

Condoms are certainly necessary for preventing the transmission of STIs, but they are also an effective method of contraception when used carefully, with spermicide, and have shown to be more effective than the Pill used alone. Then there's always the emergency contraceptive pill, which I'd rather see fit to take once a year or so than take the regular Pill every day.

I am finding that being aware of when I am fertile and when I am not is calming to the paranoia - that way, if there is a condom accident you have a reasonable understanding of the need to worry. I am not confident enough to decide I definitely don't need back up at that point, but I am getting there.

So I am sorry to have promoted any confusion here - I just hate to see myself, and other women, go nuts every month as a result of being somewhat scared of our own bodies.

"ALWAYS, ALWAYS, ALWAYS use a condom in addition to your regular method of birth control." - Male here. If condoms are the only option then I'd rather not have penetrative intercourse, and go with something like mutual masturbation instead. I think the best answer to STIs is to get tested with your partner before having that kind of sex. Not great for spontaneous casual encounters, but I've never been very successful at attracting those.

I've always thought the focus on condoms in sex ed was counterproductive, because as soon as teens become sexually active a lot of them will discover how much they dislike the things and may stop using birth control entirely. If I could take an oral contraceptive or an injection then I would, as it is I trust my partner's method.

Another male here - That's unfortunate for you, however, don't assume everyone else experiences things the same way you do. I do not mind condoms at all, and I can't think of any friends that have complaints either. Most of them are just happy to get laid. Have you tried special condoms, like extra thin, or Pleasure Plus? I actually come faster with PP condoms than sex without a condom.

My girlfriend is very wary of messing with her hormones, and dislikes the idea of taking a pill every day, especially with all the possible side effects (depression, weight gain, loss of sex drive, to name a few). I don't think it's fair to force her to go through that just so I can come a little quicker (which is generally considered a bad thing anyways).

I think we are getting two things confused here. There is birth control and then there is STI prevention, and indeed, that is when doubling up makes a lot of sense. The Pill, IUD, Patch, Depo, Nuva Ring, etc., does not prevent HIV or other STIs, only a barrier method (female or male condom) are effective for this. I don't think this conversation is complete without talking about STIs prevention along with pregnancy prevention. The same confusion exists around both.

I never got sex ed. I remember once in school, we had a program called "Aim For Success!" and little booklets were handed out that basically said if you have sex, you will get a disease and die, and since you're not a "dog" or a "rat" you should be able to control your sexual urges. That's why I was so ignorant in my teens.
Luckily I knew my way around the internet ;)